Chapter 31 Transcultural and Social Aspects of Nutrition

Ethnic Influences on Food Choices Culture affects the way a person thinks, feels, and behaves, as well as eating habits. Ethnic and religious factors may play an important part in food acceptance, especially during illness. To provide optimal care, understand the transcultural aspects of food and eating, and work within a person’s cultural context to promote optimal nutrition.

Acculturation Acculturation The process that occurs as individuals adopt the beliefs, values, attitudes, and behaviors of the dominant culture. Dietary practices are changing rapidly among younger people. Often, individuals are more influenced by the region in which they live and the availability of food products in that region than by their own specific ethnic or cultural background.

Dietary Practices of Ethnic Groups Anglo-American Excess amounts of simple sugars, fried foods, and calories Obesity, hypertension, and diabetes African Americans Diet may be high in fat (fatty meats, fried foods), sodium (salted meats), and sugar Hypertension, heart disease, and obesity

Dietary Practices of Ethnic Groups (cont’d) Latino Americans Foods are believed to be either “hot” or “cold,” and this theory may affect food choices during illness. Mexican Americans Food traditionally considered to be hot or cold should be balanced. Fried foods and limited amounts of milk and milk products, are common. Obesity and diabetes

Dietary Practices of Ethnic Groups (Cont’d) Caribbean Eating patterns reflect those of the country from which a person originated. Cuban Fried foods, especially fish, poultry, eggs, and rice are served, as are many varieties of beans. Use limited amounts of milk; therefore, calcium levels may be deficient.

Dietary Practices of Ethnic Groups (cont’d) Puerto Rican Limited use of meats, most food is cooked for long periods or fried, malt beer may be given to children Diet may be low in calcium. Asian Americans Lactose intolerance is common; extensive use of soy sauce and other high-sodium seasonings Cardiac diseases, hypertension, diabetes, cancer, and obesity risk

Dietary Practices of Ethnic Groups (cont’d) Chinese Observe the yin–yang balance, especially during illness High in fiber, starch, and many nutrients Low in fat, may be low in protein, and often high in sodium Stir-frying and steaming are common cooking methods Liver problems, hepatitis, and lung cancer

Dietary Practices of Ethnic Groups (cont’d) Japanese Use little meat and animal fat, many vegetables, raw fish (sashimi) and sushi are common Milk is rarely used by adults. Broiling, steaming, boiling, and stir-frying Korean Rice is served at every meal; seafood accounts for most of the animal protein; beef; Korean ginseng for healing and maintaining health High sodium levels in diet can lead to hypertension.

Dietary Practices of Ethnic Groups (cont’d) Filipino Americans Traditionally considered nutritionally complete because their basic staples are vegetables, fruits, and fish. Rice is believed to give a person energy; garlic and onions are believed to lower blood pressure. High sodium levels in the diet can lead to hypertension. “Hot-and-cold” food principle

Dietary Practices of Ethnic Groups (Cont’d) Southeast Asian Rice, fish, soybean products, a wide variety of fruits and vegetables; soft drinks and sweets are eaten at every meal. Milk is rarely used by adults. Cooking styles differ Native Americans Lactose intolerance; food has great religious and social significance; diets may be deficient in calcium, riboflavin, and vitamins A and C Obesity and diabetes

Dietary Practices of Ethnic Groups (cont’d) Asian Indian Based on the region of origin and the form of religion practiced Hindus rarely eat beef and may refrain from eating gelatin-based products; fasting is a common practice Deficient in protein, iron, and vitamin A Diabetes, hypertension, cardiovascular disease, cancer, osteoporosis for women, respiratory infections, intestinal infections, anemia, protein- energy malnutrition, and the associated complications

Dietary Practices of Ethnic Groups (cont’d) Middle Eastern Americans Vegetables and legumes are often the entree; all forms of pork are customarily forbidden; large quantities of fat added to food Women may eat only after the men and children are fed. Calcium and protein intake may be inadequate.

Question Is the following statement true or false? The use of home-based or herbal remedies by any culture may be contraindicated with Western-style pharmaceuticals.

Answer True Holistic herbs, hot–cold remedies, or over-the-counter treatments may be contraindicated with Western-style pharmaceuticals. For example, dark green leafy vegetables, such as collards or kale, are contraindicated with products such as aspirin (salicylates) or ibuprofen, and they can interfere with the effectiveness of blood-thinning medications such as warfarin (Coumadin).

Dietary Practices Related to Islam Dietary laws are similar to Jewish kosher laws. Alcoholic beverages are not allowed. They fast for a month each year, avoiding food from dawn until after dark. Honey, dates, milk, meat, seafood, and olive oil

Dietary Practices Related to Judaism Kosher eating demands Separate dishes, pans, and silverware are used to prepare and to serve meat and dairy foods. Meat and dairy may not be eaten at the same meal. Pork products, rabbit, shellfish, and scavenger fish are not allowed. Meats must be slaughtered by a ritual method and only the front quarter of the animal may be eaten. Food must be prepared ahead of time for the Sabbath; certain days of fasting are observed.

Dietary Practices Related to Mormon Do not use alcoholic beverages or stimulants (coffee, tea, or caffeine-containing carbonated beverages) Observe “fast offerings,”—giving up two meals on the first Sunday of each month. Live by a health code and the Word of Wisdom; they are to preserve their bodies and maintain the best possible health. Meat is eaten sparingly and “in season” (winter).

Dietary Practices Related to Roman Catholicism Dietary and fasting regulations are mostly voluntary. Some abstain from eating meat on Fridays. Most must fast and abstain from meat on Fridays during Lent. Ash Wednesday and Good Friday are observed as days of fast and abstinence. Do not eat or drink (except water) for 1 hour before taking Holy Communion.

The Vegetarian Choice Vegans Strict vegetarians; exclude all animal products from their diet. Lacto-vegetarians Eat plant foods and dairy products (no eggs). Ovo-vegetarians Eat plant foods and eggs (no dairy products). Lacto-ovo vegetarians Eat plant foods, dairy products, and eggs.

The Vegetarian Diet Vegetarians have lower rates of coronary artery disease, hypertension, non–insulin-dependent diabetes, and obesity, and lower mortality rates from colon cancer. Plant sources of protein provide sufficient amounts of essential and nonessential amino acids. Likely to consume an adequate amount of each nutrient, as long as they meet their calorie needs. Specific dietary recommendations for vegetarians are available in the Dietary Guidelines for Americans.

Question A vegan diet would include which of the following? a. Only vegetables b. Vegetables and fish c. Vegetables and eggs d. Vegetables and dairy products e. Vegetables, eggs, and dairy products

Answer a. Only vegetables A vegan diet consists of only vegetables all animal products are excluded from their diet. Lacto-vegetarians eat plant foods and dairy products (no eggs). Ovo-vegetarians eat plant foods and eggs (no dairy products). Lacto-ovo vegetarians eat plant foods, dairy products, and eggs.

Food Choice and Economic Conditions Food is relatively inexpensive in the United States. More affluent people tend to eat at restaurants more often and may eat more fat due to a higher intake of cheese, meat, fish, and poultry. When income rises, people tend to eat fewer eggs, rice, and beans. People with lower incomes may skip meals. The homeless or “street people” may beg or look through trash for food.

Food Choice and Emotional State Emotional factors may affect the eating patterns of the client in a healthcare facility. Food may become a reward. Purees of certain foods may be considered “for babies.” Clients who are sad, lonely, or depressed may overeat or refuse to eat. Snacking leads to poor nutrition and can be a sign of eating for emotional comfort.

Food Choice and Social Factors Some guidelines to provide a sense of social involvement for clients during meals include: Visit the client for a few minutes. Allow two clients to eat together. In a double room, open the curtain. Let clients meet in a common lounge for meals. Encourage family members to visit at mealtime. Turn on the television or radio. Place flowers nearby.

Food Choice and Physical Factors Clients experiencing illness may not be well enough to eat, and the nurse must take time to feed them. When nutritional needs are increased, obtaining an adequate amount of nutrients to treat acute illness takes precedence over following a low-fat or low-calorie diet for chronic disease prevention. Malnutrition is common among those with AIDS; therefore, increased calorie and protein intake is required to replenish losses. Other diet modifications may be necessary to alleviate symptoms or complications.

Food Fads and Fallacies Quick weight-loss schemes and food fads are big business in the United States. Direct toxicity and failure to seek legitimate healthcare are other possible outcomes that can significantly affect health. Clients with specific concerns about food fads or who may be at risk for health problems because of them should be directed to a dietitian.

Question What criteria of a fad diet should one look for before following the latest diet? a. It forbids any type of snacking. b. It does not recommend exercise. c. It recommends the use of pills or potions. d. It is a collection of rigid menus. e. It uses food from each of the major food groups.

Answer e. It uses food from each of the major food groups, not eliminating any as “bad,” unhealthy, or dangerous. A diet plan should use food from each of the major food groups, not eliminating any as “bad,” unhealthy, or dangerous. The number of servings recommended from each food group compares with the suggestions in the MyPlate framework of 2011.

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